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Feet - and first shoes

Babies’ feet

At birth and throughout the first year of life, babies’ feet are very different from yours. They are a different shape, being wider in the forefoot and narrow at the heel with the toes often curling easily. They are designed to function barefoot, so if they are cramped by tight bootees, socks, stretch suits or pram shoes, the toes can’t straighten out and grow properly. Try to keep your baby’s feet as free as possible and make sure bootees and socks leave enough room for their toes, both in length and width.


The bones are also undeveloped at this stage and consist solely of cartilage, so they are very soft and pliable. There are twenty six bones in each foot which gradually develop throughout infancy, becoming bony by the age seven or eight. 

First steps

Do not force your baby to walk; they will do so naturally and in their own time. The age at which a baby takes his or her first steps varies quite a lot between individuals. It can occur between 10 and 18 months, but later than this does not imply anything is wrong.

First shoes

Don’t put your baby into proper shoes in the early stages of walking, as they are unnecessary and in fact may affect the growth. It is wise to allow your baby to walk barefoot in order to strengthen the muscles in the feet. However make sure there is no risk of injury to the feet by ensuring the floor is clear of obstruction and clean.
Once ready to walk outside, the provision of shoes becomes necessary. Remember to take the following points into consideration whenever you buy shoes for your child:

  • Always have your child’s feet measured by a qualified fitter for each new pair of shoes. Children under four years old should have their feet measured every six to eight weeks. Those over four should have their feet measured every ten to twelve weeks. 
  • Shoes should be about 1 cm (a bit less than 1/2 in) beyond the longest toe and wide enough for all the toes to lie flat. 
  • Shoes with a lace, buckle or velcro fastening hold the heel in place and stop the foot slipping forward and damaging the toes. If the heel of a shoe slips off when your child stands on tiptoe, it doesn’t fit. 
  • Buy footwear made of natural materials, i.e. leather, cotton or canvas as these materials ‘breathe’. Plastic shoes make feet perspire and may cause fungal infections and abrasions. 
  • Never rely on the question ‘do they feel comfortable?’ Because children’s bones are soft, so distortion and cramping can occur without your child feeling it. 
  • Never buy second-hand shoes or hand shoes down as these take on the shape of the previous owner and will rub and not support vital areas.


Early care

Whenever possible you should encourage your baby to kick and exercise free from the constrictions of clothing. This will enable the muscles of the feet and legs to strengthen ready for when walking begins.


Babies and small children's feet grow at an incredibly rapid rate, so the fit of socks and baby-grows should be monitored continually. If they begin to look even slightly restrictive, change the garment for the next size up. Bedclothes should not be tucked in too tightly as this can also be restrictive to your baby's feet.


Baby's nails sometimes curl round and follow the contours of the toe. This is quite normal and is due to the thinness of the nail in the early months. They will soon toughen and develop a more conventional free edge. Never cut down or probe into the sides of the nail, and always trim the nails straight across and not too short.


Common foot problems

Don’t be concerned if your baby appears to be walking flat-footed. In the early stages of development this is quite normal and gives them a more stable base until the legs and feet have gained strength.


It is also quite common for toddlers to walk with their feet apart or for young children to appear to be ‘bow-legged’, ‘knock-kneed’ or walk with their toes turned in or out. Most minor foot problems in children correct themselves. But if you are worried about your child’s feet or how he or she walks in any way, talk to your doctor or health visitor. If necessary, your child can be referred to a chiropodist, orthopaedic surgeon or paediatric physiotherapist.

Bow legs – a small gap between the knees and ankles when the child is standing up is normally seen until the child is two. If the gap is pronounced or it does not correct itself, check with your doctor or health visitor. Very occasionally, this could be a sign of rickets.
Knock knees – this is when a child stands with his or her knees together and the ankles are at least 2.5 cm (1 in) apart. Between the ages of two and four, a gap of 6 to 7 cm (2 to 23/4 in) is considered normal. Knock knees usually improve and correct themselves by the age of six.


In-toeing (pigeon-toed) – here the child’s feet turn in. The condition usually corrects itself by the age of eight or nine and treatment is not usually needed.


Out-toeing (feet point outwards) – again this condition usually corrects itself and treatment is not needed in most cases.
Flat feet – if when your child stands on tiptoe the arch forms normally, no treatment is needed.


Tiptoe walking – if your child walks on tiptoes, talk to your doctor or health visitor.


 

We are indebted to Health Promotion England for their help in compiling this section.